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Batista RL, Mendonca BB. The Molecular Basis of 5α-Reductase Type 2 Deficiency. Sex Dev 2022; 16:171-183. [PMID: 35793650 DOI: 10.1159/000525119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/13/2022] [Indexed: 11/19/2022] Open
Abstract
The 5α-reductase type 2 enzyme catalyzes the conversion of testosterone into dihydrotestosterone, playing a crucial role in male development. This enzyme is encoded by the SRD5A2 gene, which maps to chromosome 2 (2p23), consists of 5 exons and 4 introns, and encodes a 254 amino acid protein. Disruptions in this gene are the molecular etiology of a subgroup of differences of sex development (DSD) in 46,XY patients. Affected individuals present a large range of external genitalia undervirilization, ranging from almost typically female external genitalia to predominantly typically male external genitalia with minimal undervirilization, including isolated micropenis. This is an updated review of the implication of the SRD5A2 gene in 5α-reductase type 2 enzyme deficiency. For that, we identified 451 cases from 48 countries of this particular 46,XY DSD from the literature with reported variants in the SRD5A2 gene. Herein, we present the SRD5A2 mutational profile, the SRD5A2 polymorphisms, and the functional studies related to SRD5A2 variants to detail the molecular etiology of this condition.
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Affiliation(s)
- Rafael L Batista
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia, do Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Endocrine Oncology Unit, Instituto do Câncer do Estado de São Paulo, ICESP, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Berenice B Mendonca
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia, do Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Hu J, Xu Z, Ye Z, Li J, Hao Z, Wang Y. The association between single nucleotide polymorphisms and ovarian cancer risk: A systematic review and network meta-analysis. Cancer Med 2022; 12:541-556. [PMID: 35637613 PMCID: PMC9844622 DOI: 10.1002/cam4.4891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The relationship between single nucleotide polymorphisms (SNPs) and ovarian cancer (OC) risk remains controversial. This systematic review and network meta-analysis was aimed to determine the association between SNPs and OC risk. METHODS Several databases (PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang databases, China Science and Technology Journal Database, and China Biology Medicine disc) were searched to summarize the association between SNPs and OC published throughout April 2021. Direct meta-analysis was used to identify SNPs that could predict the incidence of OC. Ranking probability resulting from network meta-analysis and the Thakkinstian's algorithm was used to select the most appropriate gene model. The false positive report probability (FPRP) and Venice criteria were further tested for credible relationships. Subgroup analysis was also carried out to explore whether there are racial differences. RESULTS A total of 63 genes and 92 SNPs were included in our study after careful consideration. Fok1 rs2228570 is likely a dominant risk factor for the development of OC compared to other selected genes. The dominant gene model of Fok1 rs2228570 (pooled OR = 1.158, 95% CI: 1.068-1.256) was determined to be the most suitable model with a FPRP <0.2 and moderate credibility. CONCLUSIONS Fok1 rs2228570 is closely linked to OC risk, and the dominant gene model is likely the most appropriate model for estimating OC susceptibility.
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Affiliation(s)
- Jia Hu
- Department of GastroenterologyThe Second Xiangya Hospital, Central South UniversityChangshaChina,Research Center of Digestive DiseaseThe Second Xiangya Hospital, Central South UniversityChangshaChina
| | - Zhe Xu
- Department of Pharmacy, Xiangya HospitalCentral South UniversityChangshaChina
| | - Zhuomiao Ye
- Department of Oncology, Xiangya HospitalCentral South UniversityChangshaChina
| | - Jin Li
- Xiangya School of MedicineCentral South UniversityChangshaChina
| | - Zhinan Hao
- Department of Gastrointestinal SurgeryHebei General HospitalShijiazhuangChina
| | - Yongjun Wang
- Department of GastroenterologyThe Second Xiangya Hospital, Central South UniversityChangshaChina,Research Center of Digestive DiseaseThe Second Xiangya Hospital, Central South UniversityChangshaChina
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Luo Y, Huang X, Zhan J, Zhang S. Role of CD5L and SRD5A2 as Prognostic Biomarkers for Hepatocellular Carcinoma. Int J Gen Med 2021; 14:9247-9260. [PMID: 34880664 PMCID: PMC8646114 DOI: 10.2147/ijgm.s337769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/18/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose Due to the limitations of currently available biomarkers, new biomarkers are needed to accurately predict the prognosis of patients with hepatocellular carcinoma (HCC) patients. Methods In this study, we screened for differentially expressed genes (DEGs) in the tumor and the adjacent tissues using the four gene expression array (GSE14520, GSE45267, GSE121248, GSE62232) of the Gene Express Omnibus (GEO) database. Results Subsequently, 47 overlapping DEGs were identified in four GEO datasets, which were mostly located on chromosomes 5q and 6q, distributed in the liver and CD105-positive endothelial cells, and closely related to HCC. Function enrichment revealed 47 DEGs were related to HCC, and involved in steroid /lipid /retinol metabolism, bile secretion and p53 signalling pathway. The Kaplan–Meier plotter analysis (http://www.kmplot.com/) identified 26 and 40 genes associated with the 5-year overall survival (OS) and relapse-free survival (RFS). We found that CD5L and SRD5A2 were independent prognostic factors for 5-year OS (P=0.036) and RFS (P=0.044) in HCC patients from GSE14520, respectively. Clinicopathological features including BCLC stage, cirrhosis, and risk signature for predicted metastasis were used to construct and validate a nomogram for 5-year OS with C-index of 0.732 and 0.717 in the training and validation cohort, respectively. SRD5A2, BCLC stage and gender was independent prognostic factors for RFS which were used to build a nomogram with the C-index of 0.666 and 0.682 in the training and validation cohort, respectively. Conclusion CD5L can facilitate individualized, targeted therapy for HCC patients.
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Affiliation(s)
- Yunxiu Luo
- Department of Radiation Oncology, Hainan Cancer Hospital, Affiliated Cancer Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
| | - Xiaopeng Huang
- Department of Radiation Oncology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
| | - Jiabin Zhan
- Department of Otolaryngology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
| | - Shuai Zhang
- Department of Radiation Oncology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan Province, People's Republic of China
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Batista RL, Mendonca BB. Integrative and Analytical Review of the 5-Alpha-Reductase Type 2 Deficiency Worldwide. APPLICATION OF CLINICAL GENETICS 2020; 13:83-96. [PMID: 32346305 PMCID: PMC7167369 DOI: 10.2147/tacg.s198178] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/20/2020] [Indexed: 12/12/2022]
Abstract
Introduction The conversion of testosterone into dihydrotestosterone is catalyzed by the 5α-reductase type 2 enzyme which plays a crucial role in the external genitalia virilization. It is encoded by the SRD5A2 gene. Allelic variants in this gene cause a 46,XY DSD with no genotype-phenotype relationship. It was firstly reported in the early 70s from isolated clusters. Since then, several cases have been reported. Putting together, it will expand the knowledge on the molecular bases of androgen milieu. Methods We searched for SRD5A2 allelic variants (AV) in the literature (PubMed, Embase, MEDLINE) and websites (ensembl, HGMD, ClinVar). Only cases with AV in both alleles, either in homozygous or compound heterozygous were included. The included cases were analyzed according to ethnicity, exon, domain, aminoacid (aa) conservation, age at diagnosis, sex assignment, gender reassignment, external genitalia virilization and functional studies. External genitalia virilization was scored using Sinnecker scale. Conservation analysis was carried out using the CONSURF platform. For categorical variables, we used X2 test and Cramer's V. Continuous variables were analyzed by t test or ANOVA. Concordance was estimated by Kappa. Results We identified 434 cases of 5ARD2 deficiencies from 44 countries. Most came from Turkey (23%), China (17%), Italy (9%), and Brazil (7%). Sixty-nine percent were assigned as female. There were 70% of homozygous allelic variants and 30% compound heterozygous. Most were missense variants (76%). However, small indels (11%), splicing (5%) and large deletions (4%) were all reported. They were distributed along with all exons with exon 1 (33%) and exon 4 (25%) predominance. Allelic variants in the exon 4 (NADPH-binding domain) resulted in lower virilization (p<0.0001). The codons 55, 65, 196, 235 and 246 are hotspots making up 25% of all allelic variants. Most of them (76%) were located at conserved aa. However, allelic variants at non-conserved aa were more frequently indels (28% vs 6%; p<0.01). The overall rate of gender change from female to male ranged from 16% to 70%. The lowest rate of gender change from female to male occurred in Turkey and the highest in Brazil. External genitalia virilization was similar between those who changed and those who kept their assigned gender. The gender change rate was significantly different across the countries (V=0.44; p<0.001) even with similar virilization scores. Conclusion 5ARD2 deficiency has a worldwide distribution. Allelic variants at the NADPH-ligand region cause lower virilization. Genitalia virilization influenced sex assignment but not gender change which was influenced by cultural aspects across the countries. Molecular diagnosis influenced on sex assignment, favoring male sex assignment in newborns with 5α-reductase type 2 deficiency.
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Affiliation(s)
- Rafael Loch Batista
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia, do Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Berenice Bilharinho Mendonca
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia, do Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Foreman M, Hare L, York K, Balakrishnan K, Sánchez FJ, Harte F, Erasmus J, Vilain E, Harley VR. Genetic Link Between Gender Dysphoria and Sex Hormone Signaling. J Clin Endocrinol Metab 2019; 104:390-396. [PMID: 30247609 DOI: 10.1210/jc.2018-01105] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 09/18/2018] [Indexed: 12/15/2022]
Abstract
CONTEXT There is a likely genetic component to gender dysphoria, but association study data have been equivocal. OBJECTIVE We explored the specific hypothesis that gender dysphoria in transgender women is associated with variants in sex hormone-signaling genes responsible for undermasculinization and/or feminization. DESIGN Subject-control analysis included 380 transgender women and 344 control male subjects. Associations and interactions were investigated between functional variants in 12 sex hormone-signaling genes and gender dysphoria in transgender women. SETTING Patients were recruited from the Monash Gender Clinic, Monash Health, Melbourne, Australia, and the University of California, Los Angeles. PATIENTS Caucasian (non-Latino) transgender women were recruited who received a diagnosis of transsexualism [Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV) or gender dysphoria (DSM-V)] pre- or postoperatively. Most were receiving hormone treatment at the time of recruitment. MAIN OUTCOME MEASURED Genomic DNA was genotyped for repeat length polymorphisms or single nucleotide polymorphisms. RESULTS A significant association was identified between gender dysphoria and ERα, SRD5A2, and STS alleles, as well as ERα and SULT2A1 genotypes. Several allele combinations were also overrepresented in transgender women, most involving AR (namely, AR-ERβ, AR-PGR, AR-COMT, CYP17-SRD5A2). Overrepresented alleles and genotypes are proposed to undermasculinize/feminize on the basis of their reported effects in other disease contexts. CONCLUSION Gender dysphoria may have an oligogenic component, with several genes involved in sex hormone-signaling contributing.
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Affiliation(s)
| | - Lauren Hare
- Hudson Institute of Research, Melbourne, Victoria, Australia
| | - Kate York
- Hudson Institute of Research, Melbourne, Victoria, Australia
| | | | | | - Fintan Harte
- Monash Gender Clinic, Monash Health, Melbourne, Victoria, Australia
| | | | - Eric Vilain
- Children's National Health System, Washington, DC
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Ou C, Li H, Liu JH, Drummen GPC, Zhu B, Huang LS, Huang Y, Li LQ. Meta-analysis of transforming growth factor β receptor I 6A/9A gene polymorphism and breast cancer risk: the picture remains murky. Biomarkers 2016; 20:487-94. [PMID: 26616150 DOI: 10.3109/1354750x.2015.1096307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Breast cancer is currently the second most common cancer worldwide and the most frequent malignant tumor among women. However, the exact contribution of various allelic alterations remains unclear. This meta-analysis was conducted to evaluate the association of the transforming growth factor β receptor I 6A/9A (TβR-I 6A/9A) gene polymorphism with breast cancer risk. Relevant studies were identified from PubMed and Cochrane Library on 1 October 2013, and eligible reports were recruited and synthesized. Eleven reports that included a total of 12 studies were recruited into this meta-analysis for the association of the TβR-I 6A/9A gene polymorphism and breast cancer risk. The results indicated that overall the TβR-I 6A allele was associated with breast cancer risk (OR = 1.33, 95% CI: 1.02-1.73, p = 0.04). However, the TβR-I 6A/6A and 9A/9A genotypes were not associated with an increased risk of developing breast cancer (6A/6A: OR = 1.71, 95% CI: 0.95-3.08, p = 0.07; 9A/9A: OR = 0.82, 95% CI: 0.66-1.02, p = 0.08). In the Caucasian population, no such association could be established. In conclusion, the TβR-I 6A allele might represent a risk factor for breast cancer risk, but significantly larger data sets from a larger number of studies, including studies that allow ethnicity, subgroup analysis and environmental impact evaluation, are required to maximize statistical significance and meta-analysis robustness.
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Affiliation(s)
- Chao Ou
- a Department of Clinical Laboratory, The Affiliated Tumor Hospital of Guangxi Medical University , Nanning , China
| | - Hang Li
- b Department of Physical Diagnosis, The Affiliated Tumor Hospital of Guangxi Medical University , Nanning , China
| | - Jiang-Hua Liu
- c Department of Emergency, The First Affiliated Hospital of Guangxi Medical University , Nanning , China
| | - Gregor P C Drummen
- d Cellular Stress and Ageing Program, Bionanoscience and Bio-Imaging Program, Bio&Nano-Solutions , Düsseldorf , Germany , and
| | - Bo Zhu
- a Department of Clinical Laboratory, The Affiliated Tumor Hospital of Guangxi Medical University , Nanning , China
| | - Ling-Sha Huang
- a Department of Clinical Laboratory, The Affiliated Tumor Hospital of Guangxi Medical University , Nanning , China
| | - Ying Huang
- a Department of Clinical Laboratory, The Affiliated Tumor Hospital of Guangxi Medical University , Nanning , China
| | - Le-Qun Li
- e Department of Hepatobiliary Surgery, The Affiliated Tumor Hospital of Guangxi Medical University , Nanning , China
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Eren E, Edgünlü T, Asut E, Karakaş Çelik S. Homozygous Ala65Pro Mutation with V89L Polymorphism in SRD5A2 Deficiency. J Clin Res Pediatr Endocrinol 2016; 8:218-23. [PMID: 26761946 PMCID: PMC5096479 DOI: 10.4274/jcrpe.2495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Deficiency of steroid 5-alpha reductase type 2 (5αRD2) is a rare autosomal recessive disorder caused by mutations in the SRD5A2 gene. A defect in the 5-alpha reductase enzyme, which ensures conversion of testosterone into dihydrotestosterone, leads to disorders of sex development. This study presents the clinical and genetic results of patients with 5αRD2 deficiency. METHODS 5αRD2 deficiency was detected in 6 different patients from 3 unrelated families. All patients were reared as girls. Two of the patients presented with primary amenorrhea, one with primary amenorrhea and rejection of female gender, and the others with masses in their inguinal canals. Chromosome and sex-determining region Y (SRY) gene analyses were performed in all patients. Additionally, five exons of the SRD5A2 gene were amplified with polymerase chain reaction in the obtained DNA samples and evaluated. RESULTS While 46,XY was identified in 5 patients, 47,XXY was detected in one patient. The SRY gene was positive in all patients. The p.Ala65Pro (c193G>C) mutation and V89L polymorphism were observed in exon 1 of the SRD5A2 gene in all patients. CONCLUSION Identification of this mutation and polymorphism is a significant indicator of presence of 5αRD2 deficiency in Southeastern Turkey, a geographical region where consanguineous marriages are also highly common.
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Affiliation(s)
- Erdal Eren
- Harran University Faculty of Medicine, Department of Pediatric Endocrinology, Şanlıurfa, Turkey; Present position: Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey, Phone: +90 224 295 05 40 E-mail:
| | - Tuba Edgünlü
- Sıtkı Koçman University Faculty of Health Sciences, Department of Medical Biology, Muğla, Turkey
| | - Emre Asut
- Uludağ University Faculty of Medicine, Department of Pediatrics, Bursa, Turkey
| | - Sevim Karakaş Çelik
- Bülent Ecevit University Faculty of Medicine, Department of Medical Genetics, Zonguldak, Turkey
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